Population-based analysis reveals a greater increase in congenital syphilis incidence compared to adult syphilis, suggesting urgent healthcare gaps.
Objective To compare temporal trends in congenital syphilis with adult primary and secondary syphilis incidence in Texas. Study Design Population-based retrospective trend analysis using CDC WONDER data from 2016–2023. Results Congenital syphilis incidence increased from 17.5 to 238.6 per 100,000 live births, representing a 12.6-fold increase. The annual percent change (APC) was 29.7% (95% CI 27.9–31.6; p<0.001). Adult primary and secondary syphilis increased from 7.0 to 15.0 per 100,000 population (113% increase), with an APC of 13.1% (95% CI 12.5–13.8; p<0.001). The increase in congenital syphilis significantly outpaced adult trends (interaction p<0.001). Conclusion Congenital syphilis in Texas has increased at a markedly greater rate than adult syphilis, suggesting failures in prenatal screening, treatment, or care access beyond rising community transmission alone.
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Toro et al. (2026) studied this question.
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